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Looking back from what, by comparison, may appear a more enlightened age, the extreme violence of the opposition to the simple, and now almost obvious, truths propounded by Copernicus, Darwin and Freud, seem almost inexplicable - or rather it would so seem if Freud himself had not explained it as the inevitable response to three major blows to human narcissism. The thesis I hope to develop here is that this narcissism, which is still with us though it may take other forms, is a psychotic trait so pervasive in our species that to possess it is commonly considered to be not merely ‘normal’, but essential to health.
A critical illustration of what I mean is to be found, in an easily recognizable form, in those patients whose illness appears to consist in a ‘loss of confidence’. In such cases, analysis will probably reveal that their former ‘confidence’ had in it more than a just assessment of their capacities in relation to their tasks. It contained, in its affirmation of a special worth, a manic quality, as a defence against a sense of worthlessness, which differs only in degree, but not in kind, from a megalomanie delusion. To them this ‘delusion’ was a part of their ‘health’ which they hope the analyst will restore to them. Moreover, their friends and relatives entirely share their view. They had before been functioning successfully - perhaps even brilliantly—on the basis of a good, to the analyst an exaggerated, opinion of themselves which they have now lost. No wonder, then, that everyone, except the analyst, believes this ‘good’, in reality exaggerated, and so delusional, opinion to be an attribute of health.